T1w/T2w ratio shows heterogeneous regional changes in relapsing-remitting MS and links to memory impairment

In relapsing-remitting MS, T1w/T2w ratio was lower in white-matter lesions (p<0.001) and caudate (p=0.025) but higher in putamen/pallidum (p<0.05). Higher ratios in left entorhinal cortex and caudate tracked with better learning/memory (β=1.397–3.505, FDR-corrected p<0.05).

• Cross-sectional study: 72 RRMS patients vs. 70 matched healthy controls underwent T1w/T2w ratio mapping and neuropsychological testing.
• Memory scores positively associated with ratio in left entorhinal cortex, bilateral caudate, and lesional segments of left posterior thalamic radiation/sagittal stratum (β range 1.397–3.505, all FDR p<0.05).
• Single-center, cross-sectional design limits causal inference; external validation is needed before clinical use.

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